Bilateral choroid plexus resection in a 9p hexasomy/tetrasomy mosaic patient.

Previous reports have shown that a gain of the chromosome 9 short arm (9p) is associated with choroid plexus hyperplasia (CPH). Furthermore, CPH can lead to communicating hydrocephalus; however, no cases of CPH with 9p gain requiring choroid plexus resection have been reported. Here, we describe the first case in which a 9p hexasomy/tetrasomy mosaic patient required choroid plexus resection for hydrocephalus. This finding suggested that the 9p copy number is correlated with CPH severity.

Early infantile-onset Leigh syndrome complicated with infantile spasms associated with the m.9185 T > C variant in the MT-ATP6 gene: Expanding the clinical spectrum.

BACKGROUND: The mitochondrial DNA MT-ATP6 gene encodes the ATP6 subunit of the mitochondrial ATP synthase. The m.9185 T > C variant in MT-ATP6 has been reported to cause various neurological disorders including late-onset Leigh syndrome (LS). To our knowledge, there has been no reported case of infantile-onset LS associated with the m.9185 T > C variant. Herein, we report a patient with early-onset LS complicated with infantile spasms who exhibited profound developmental delay. CASE REPORT: A 3-month-old Japanese girl presented with focal seizures. Brain magnetic resonance imaging (MRI) revealed bilateral lesions in the basal ganglia and cerebral peduncle. Laboratory evaluation demonstrated marked elevations of lactate and pyruvate in both venous blood and cerebrospinal fluid. At 6 months, she developed infantile spasms, which were ceased by adrenocorticotropic hormone therapy. At 2 years of age, she was bedridden due to hypotonic quadriplegia and was unable to make eye contact. Whole-exome sequencing identified apparently de novo homoplasmic m.9185 T > C variant in her blood. CONCLUSION: This is the first case report describing early infantile-onset LS associated with the m.9185 T > C variant, and thereby broadens the phenotypic spectrum of m.9185 T > C-related disorders.

Distinctive solution conformation of phosphatase inhibitor CPI-17 substituted with aspartate at the phosphorylation-site threonine residue.

We present solution NMR structures for wild-type and mutated forms of CPI-17, a phosphoinhibitor for protein phosphatase 1. Phosphorylation of Thr38 of CPI-17 produces a >1000-fold increase in inhibitory potency for myosin phosphatase. We compared the 1H-15N heteronuclear single quantum coherence spectroscopy (HSQC) chemical shifts of wild-type CPI-17, partially phosphorylated CPI-17 and CPI-17 with Thr38 replaced with Asp to introduce a negative charge. There was a switch in the protein conformation due to either Asp substitution or phosphorylation, so we determined the solution NMR structure of the CPI-17 T38D mutant as a model for the active (phospho-) conformation. The structures reveal a molecular switch in conformation that involves the rotation of two of the four helices in the four helix bundle. Despite this conformational switch, there was little increase in the inhibitory potency with T38D. We propose that for this inhibitor, a negative charge at residue 38 is sufficient to trigger an active conformation, but a phosphoryl group is required for full inhibitory potency against protein phosphatase-1.